Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy.

The first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March-3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March-3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.

Profiles of sleep changes during the COVID-19 pandemic: Demographic, behavioural and psychological factors.

This study aimed to evaluate changes in sleep during the COVID-19 outbreak, and used data-driven approaches to identify distinct profiles of changes in sleep-related behaviours. Demographic, behavioural and psychological factors associated with sleep changes were also investigated. An online population survey assessing sleep and mental health was distributed between 3 April and 24 June 2020. Retrospective questions were used to estimate temporal changes from before to during the outbreak. In 5,525 Canadian respondents (67.1% females, 16-95 years old: Mean ± SD = 55.6 ± 16.3 years), wake-up times were significantly delayed relative to pre-outbreak estimates (p < .001, ηp2  = 0.04). Occurrences of clinically meaningful sleep difficulties significantly increased from 36.0% before the outbreak to 50.5% during the outbreak (all p < .001, g ≥ 0.27). Three subgroups with distinct profiles of changes in sleep behaviours were identified: "Reduced Time in Bed", "Delayed Sleep" and "Extended Time in Bed". The "Reduced Time in Bed" and "Delayed Sleep" subgroups had more adverse sleep outcomes and psychological changes during the outbreak. The emergence of new sleep difficulties was independently associated with female sex, chronic illnesses, being employed, family responsibilities, earlier wake-up times, higher stress levels, as well as heavier alcohol use and television exposure. The heterogeneity of sleep changes in response to the pandemic highlights the need for tailored interventions to address sleep problems.

Owls and larks do not exist: COVID-19 quarantine sleep habits.

BACKGROUND: The coronavirus pandemic presented a unique opportunity to study the daily temporal patterns and sleep habits of humans. The question to be explored was: Are there discernible differences in sleep between the normal operational environment and the stay-at-home condition? METHODS: This international prospective study analyzed results from the sleep-wake patterns questionnaire, daily logs, and interviews. Surveys were administered to the healthy volunteers (age 15-60 y) with stay-at-home for a month or more, without previous sleep disorders and mood-related complaints; volunteers were not involved in online education/work daily timetable-related activities. RESULTS: We analyzed 3787 subjects with average stay-at-home of 65 ± 9 days. The most significant changes in sleep occurred during the first ten days when the difference between weekdays and weekends disappeared and changes occurred in napping habits. The majority of the participants (66.8%) shifted toward eveningness when the self-selected sleep was possible and 1869 volunteers appeared to be owls (49.4%), 823 (21.7%) exercised "typical" sleep, 478 (12.6%) were larks, and 617 (16.3%) participants were completely desynchronized to the end of stay-at-home. In addition, 497 participants (13.1%) alternated their sleep habits. The most of the desynchronized participants (n = 414) were older than 50 years (age correlation r = 0.80), and predominantly males (n = 297, r = 0.76). CONCLUSION: In self-selected sleep conditions, the timing of sleep and sleep habits significantly differ from those of socially and economically fixed daily routine conditions. The changes in daily temporal patterns of humans during a prolonged stay-at-home situation indicate that human sleep habits may change according to existing living conditions.